Occult cervical nodal metastasis in esophageal cancer: Preliminary results of three-field lymphadenectomy

The extent of lymphadenectomy for carcinoma of the thoracic esophagus remains debatable, A prospective study was initiated in August 1994 to evaluate the patterns of nodal spread after esophagectomy with three-field lymph node dissection, The hospital mortality rate was 3.3%. Nodal metastases occurred in 73% (22/30) of patients, The most commonly affected nodal groups were the lesser curvature nodes (57%), parahiatal nodes (42%), and the right recurrent nodes (35%), Cervical nodal metastasis occurred in 10 patients (35%) irrespective of tumor location or T status, The cervical field of dissection was as likely as the mediastinum to be a site of nodal disease, These findings should be considered when the operative strategy for esophageal carcinoma is planned.